The Assistant Medical Director of the South West Acute Hospital (SWAH) has said Covid-19 has become more "endemic" among young people but fears the virus will eventually spread through older age groups putting more pressure on hospital services.

According to Dr. Ronan O'Hare there has been a significant increase in the number of patients arriving to the Emergency Department and testing positive for the virus as well as the number of patients being admitted. There are currently less than five Covid-19 inpatients at SWAH.

"It's not like the other time," explained Dr. O'Hare. "In the previous first wave I would have known it was a relatively low incident across Fermanagh and Omagh, however that not the case now.

"I am fully aware that it is much more endemic and that sort of reliability that we had is no longer present. We have to now treat everyone as if they have Covid, not that we weren’t initially, but now there is a much higher index of suspicion.

"My fear is that it will spread up the age chain and get into the more vulnerable patient groups and that will have a very dramatic effect on the hospital."

SWAH has never relaxed their measures to fight Covid-19 from the first wave but Dr. O'Hare said that it will get to a point where capacity in the hospital will become "saturated" and in turn will have a knock on effect on services such as surgery, the emergency department and ultimately waiting lists.

"I know it is extremely difficult to adhere to the rules, particularly if you are younger and the disease doesn’t affect you. But that’s not fine when it starts to spread into the more vulnerable population. And the rules are there for a reason and I accept they are extremely hard to follow and everybody gets fatigued buts that’s ok until your granny gets it and that’s the reality."

The oncoming flu season may also have an added effect on how coronavirus is dealt with.

"Whether you get an outbreak of that superimposed on top of the Covid situation you can only plan so much and the rest you have to deal with it as it comes along and again the hospital will do its best.

"The health care service has been stressed for a significant period of time and these additional factors will have a more dramatic affect on our day to day living and people need top be very aware of this."

Speaking about the number of positive cases of Covid-19, Dr. O'Hare believes there is a significant proportion of people who are asymptomatic and that until a vaccine arrives we should be ready to live with the virus.

"The number of people testing positive is fairly irrelevant because there is a significant number maybe more who are asymptomatic who have never been tested.

"We are going to have to learn to live with disease until a vaccine comes around and I think that has been the case in the past and because the testing is ramped up so much that is why we are discovering more people who have it."

With the threat of lockdown looming for Northern Ireland to try and quell the rising cases, Dr. O'Hare praised the efforts of the people of Fermanagh and Omagh.

The area has had the fewest number of positive cases and deaths across the country.

"It has to be said the population of Fermanagh and Omagh are very, very responsive to public health advice as seen by the effect it has had in the previous wave and the number of deaths that we had.

"It used to be that our infection rate per 100,000 was less than the Shetland Islands. That’s not the case now but it’s a credit to our local population how well they have done and sustained their vigilance in such a difficult times."

The Western Health and Social Care Trust (WHSCT) had set out a rebuilding plan post-Covid and while all services have returned to SWAH there is a new way of doing things to keep everybody safe.

"All services have been reinstated albeit patients are being seen in virtual clinics. All the surgical services have been reinstated obviously this have been augmented to deal with social distancing, cleaning theatres.

"Patients in general seem to be happy with it as do the nursing and medical staff and physios and OTs that provide them.

"Everyone misses the face to face contact with patients. That’s why doctors are doctors and nurses are nurses that patient infraction."

Dr. O'Hare admits that one aspect of the new way of working that does have a profound effect on hospital staff is the visiting restrictions.

"We are in a new way of working but what does sadden me greatly and has a real emotional effect on medical, nursing staff and allied health professionals is relatives not being able to visit their loved ones. That has a very dramatic effect and I know it effect relatives and patients but it also affects us. We are the ones that are having to say no and if someone is dying you are not allowed to be close to them and it is really emotionally draining.

"It's as hard on us as it is on them. It is really so hard to say you are not allowed be with your loved one as they die."

There is a long way to go to get over Covid-19 and it will not get any easier with Dr. O'Hare concluding; "Fortunately it seems to be more endemic among younger people but it is only a matter of time before it spreads up the age curve and therefore I think this is going to be much more serious."